NMC asks Council to approve first registration fee increase in 11 years

During the 11-year freeze, there has been a 28.8% loss in the real value of the registration fee, with a resultant loss of £186m of income for the regulator up to the end of March this year.

This means that the regulator is now posting substantial deficits on an annual basis. The NMC’s reserves have fallen from £101m in March 2024 to around £49.6m now and are projected to fall to £15.9m in March 2027 if there is no increase in the fee.

The NMC says that this is an unsustainable financial position, given that the demands on its regulatory services have increased substantially – and continue to do so.

In 2015, the NMC regulated 686,782 nursing and midwifery professionals, compared to 867,935 today. This has resulted in greater demand on services such as Registration and Revalidation, while annual Fitness to Practise referrals have risen by 21% since 2015.

In simple terms, the NMC is now regulating more professionals – now accounting for around one in 50 of the working-age population – in a more complex environment, with a fee that has steadily reduced in value for over a decade.

Therefore, the Council will meet next week (28 April) to decide whether to approve an increase in the fee of the equivalent of £1.92 per month or from £120 to £143 per year. If the fee had increased in line with inflation since 2015, it would now be around £168 per year.

If the fee rise goes ahead registrants may be able to reduce the effective cost by claiming tax relief, bringing the annual cost down further, and a quarterly payment option remains available to help spread the cost throughout the year.

The proposal to increase the fee follows a 12-week consultation from 3 November 2025 to 26 January 2026.

The consultation showed strong levels of understanding of the NMC’s rationale for increasing fees. However, there was also strong opposition to the proposed increase due to concerns about the cost of living.

The NMC’s recommendation to its governing body is that a continued freeze in the fee is no longer sustainable, but it has kept the proposed rise the lowest level it can – recognising the ongoing pressures on registrants’ finances.

While recommending that registrants pay more, NMC has taken steps to control its own costs, including restructuring the organisation, reducing its workforce by around 10% (137 roles) and cutting £3.1 million from non-staff spending each year.

The consultation also shows that most registrants agree that the NMC should continue to invest in regulatory improvements:

• Better education quality assurance, ensuring new professionals are well prepared
• Stronger and clearer professional standards, reflecting modern practice
• Faster, fairer Fitness to Practise processes, reducing stress and delay
• Regulatory fairness, embedding equity, diversity and inclusion to eliminate bias
• Modern digital services, making it easier to interact with the NMC.

Paul Rees MBE, Chief Executive and Registrar of the NMC, said:

“We know from our consultation that many nurses, midwives and nursing associates remain under real financial pressure. We’re grateful to everyone who shared their views with us.

“It’s clear from the consultation that most registrants understand our financial rationale. For 11 years we’ve deliberately held the registration fee at the same level to avoid adding to cost-of-living pressures. However, this is no longer sustainable.

“We’re acutely aware of where our income comes from, and we’re committed to ensuring that every pound is used responsibly and delivers value – continuing the steady improvements we’re making across our regulatory work.

“Many registrants in the consultation also told us that they understand the importance of investing in regulatory improvements – faster, fairer processes, stronger and clearer standards, better education quality assurance, and modern digital services.

“By asking the Council to approve this increase, we’re hoping to lead the NMC into a sustainable financial future, where we’re able to meet the growing demands on our work – and to continue investing in critical change and improvement programmes, to build a new NMC that is the strong and independent regulator everyone wants to see.”

Other recent news…